Care and management of adult patients with Gender Dysphoria / Gender Incongruence in Primary Care

The Relevant Authority intends to award a single contract to the most suitable provider. This notice will be published for at least 14 days in line with best practice under the Provider Selection Regime 2023, allowing time for any enquiries to be considered. Service Overview

This service is initially a pilot with plans to then further develop and expand this service.

For the pilot, then expressions of interest are requested from existing primary and/or community care providers in Derby and Derbyshire ICB.

During the initial pilot phase, the successful provider will enable a new model of care through a GP(s) with Extended Role (GPwER) to be commissioned. This will allow general practices in NHS Derby and Derbyshire ICB to refer patients into this service to support and care and management of adult patients with gender dysphoria / gender incongruence in primary care. This supports equality of access to care and management for patients within this cohort whilst enabling further understanding of the need for this service across Joined Up Care Derbyshire.

This service will provide a specialist support service within the community to general practice where a GP and/or other healthcare professionals with additional interest / education and specialism in gender dysphoria / gender incongruence will be able to support decision making.

This service would also offer, where deemed clinically necessary and at the discretion of the service, patients to receive face to face and telephone / online consultations to support them with gender dysphoria / gender incongruence. This service will (if required) also address the care and management of those patients discharged from the Gender Identity Clinic and stable to provide long term support for patients (as such could be known as a 'step down' approach in managing their care within the community) and could provide advice, guidance and support to practices that are managing these patients.

The service will also be able to support with the prescribing and monitoring, with support from Nottinghamshire Gender Identity Clinic (GIC) of:

For Transmen: • Testosterone (IM or transdermal) • GnRH analogues (Leuprorelin or triptorelin sub cut)

For Transwomen: • Estradiol (oral or transdermal) • GnRH analogues (Leuprorelin sub cut) • Anti-androgen treatments (oral – Finasteride, Cyproterone and Spironolactone)

The service provider will need: • Expertise and experience in GD • Strong links with a GIC • Track record of delivery / engagement

For copies of the draft service specification please contact the Commissioner using the email address provided and a copy of the specification will be issued to you.

The service is a pilot, and the initial contract is for 5 years with a 6 month notice period included with effect from 01st October 2025. Annual contract value is £46,795.64. Total contract value over 5 years £233,975.00.

Interested providers should formally register their interest by emailing the ICB Primary Care team on the following email - [email protected], no later than midnight on 02 September 2025.